Giants of Yorkshire Medicine: William Hey
Just like athletes being awarded Olympic medals in 2012, Yorkshire has more than its fair share of notable medics — both past and present.
From the School of Medicine itself to the wider civic community, there are innovators in the field of medicine who have tested theories and pioneered techniques that form the basis for teaching and practice today.
Medicine Matters will be paying tribute to both the forerunners and those in current practice, through a series entitled ‘Giants of Yorkshire Medicine’, starting with William Hey.
WILLIAM HEY 1736–1819
Have you ever wondered which surgical procedures were carried out in the eighteenth century? The Brotherton’s Special Collections library contains 22 notebooks belonging to surgeon and obstetrician William Hey, a founding member of the Leeds General Infirmary in 1767. His records provide fascinating insights into the conditions he saw such as smallpox, traumatic injury and the many complications of childbirth.
Some of Hey’s notebooks have been digitalised. We can recognise several emetics, laxatives and analgesics he used, but the apothecary measures detailed (grains, scruples and drams) and recipes for poultices or juleps are less familiar. Hey routinely performed lithotomies on children and adults to remove bladder stones, a condition that was much commoner in the past.
He also carried out post-mortems, including one on his own uncle, noting that his kidneys were shrunken, his prostate enlarged and that he had a hydatid cyst on the left kidney ‘ab’t the size of a Pullet’s egg’.
He saved the life of a 12-year-old boy with a skull fracture by trepanation. Commonly he operated on patients with hernia or bowel obstruction. There was a high death rate following surgery at this time, but Hey was exemplary in his work with the poor of Leeds and his attempt to advance clinical knowledge and improve surgical techniques.
Dr Emma Storr, Honorary Associate Professor
See: https://explore.library.leeds.ac.uk/special-collectionsexplore/487660
The history of bladder stones goes back into ancient civilisation, with the oldest bladder stone on record being found in an Egyptian mummy dating back to 4800BC. The stone was composed of a uric acid core with concentric laminations of calcium phosphate and ammonium magnesium phosphate (triple phosphate stone).
This chemical composition is consistent with an original metabolic core of uric acid, which is an insoluble end product of purine (protein) metabolism, covered by layers of triple phosphate or struvite stone. This forms as a consequence of infection predominantly due to Proteus or Klebsiella and to a lesser extent E. coli.
Early bladder stones were often a reflection of an underlying metabolic cause exacerbated by a lack of clean water, inadequate hydration and subsequent infection.
Modern day bladder stones, in adults, are more commonly associated with incomplete bladder emptying either due to an enlarged prostate or as a consequence of neurological impairment of bladder function.
In the paediatric population bladder stones are rare and usually due to an underlying metabolic or anatomical abnormality. Causes include obstruction to the urinary tract, and disorders such as spina bifida and bladder exstrophy.
In contrast to Hey’s time, modern bladder stones are treated endoscopically with stone fragmentation being achieved by applying shock waves to the stone either by high frequency ultrasound or laser. Usually the patient goes home within 24 hrs, with none of the complications encountered when ‘cutting for stone’ in the past.
Adrian Joyce, Consultant in Urology MS FRCS (Urol)
